Swallowing Difficulty

Swallowing difficulty is the inability to swallow foods or liquids with ease. People who have a hard time swallowing may choke on their food or liquid when trying to swallow. Another medical name for swallowing difficulty is dysphagia. This symptom isn’t always indicative of a medical condition. In fact, swallowing difficulty may be temporary and go away on its own.

Trouble swallowing may come from an obstruction in the throat such as trapped food, a swollen throat, or medical conditions that cause the esophagus to become inflamed.

A swollen tongue or swelling in the esophagus can also cause difficulty in swallowing.

The following can also cause trouble swallowing:

• dry throat
• allergic reaction
• swollen tongue
• swollen tonsils
• esophageal reflux disease

According to Mayo Clinic, there are 50 pairs of muscles and nerves used to help you swallow (Mayo, 2011). In other words, there are lots of things that can go wrong and lead to problems swallowing.

Swallowing difficulty falls into three groups: esophageal, oropharyngeal, and unknown.

Esophageal

Esophageal dysphagia is the feeling that something is stuck in your throat. This condition is caused by:

• spasms in the lower esophagus (diffuse spasms or inability of the esophageal sphincter to relax)
• tightness in the lower esophagus (due to an intermittent narrowing of the esophageal ring)
• narrowing of the esophagus from growths or scarring
• foreign bodies lodged in the esophagus or throat
• a swelling or narrowing of the esophagus from inflammation or gastroesophageal reflux (GERD)
• scar tissue in the esophagus (due to chronic inflammation or post radiation treatment)

Oropharyngeal

Oropharyngeal dysphagia is caused by disorders of the nerves and muscles in the throat, which make the muscles weak. This makes it difficult for a person to swallow without choking or gagging. The causes of oropharyngeal dysphagia are conditions that primarily affect the nervous system such as:

• multiple sclerosis
• Parkinson’s disease
• nerve damage from surgery or radiation therapy
• post-polio syndrome

Oropharyngeal dysphagia can also be caused by cancer of the esophagus or by an obstruction in the upper throat or pharynx or pharyngeal pouches that collect food.

If you think you may have swallowing difficulty, there are certain symptoms that may be present along with difficulty swallowing.

They include:

• drooling
• a hoarse voice
• feeling that something is lodged in the throat
• regurgitation
• unexpected weight loss
• heartburn
• coughing or choking when swallowing
• pain when swallowing

These sensations may cause a person to avoid eating, skip meals, or lose their appetite.

Children who have difficulty swallowing when eating may:

• refuse to eat certain foods
• have food or liquid leaking from their mouths
• regurgitate during meals
• have trouble breathing when eating
• lose weight without trying

Talk to your doctor about your symptoms and when they began. Your doctor will do a physical examination and look at your tonsils to check for abnormalities or swelling.

More specialized tests may be needed to find the exact cause.

Barium X-Ray

A barium X-ray is often used to check the inside of the esophagus for abnormalities or blockages. During this examination, you will swallow liquid or a pill containing a dye that shows up on an abdominal X-ray. The doctor will look at the X-ray image as you swallow the liquid or pill to see how the muscles in your throat function. This will help identify any weaknesses or abnormalities.

Endoscopy

An endoscopy may be used to check all areas of your esophagus. During this examination, the doctor will insert a very thin flexible tube with a camera attachment down into your esophagus. This allows the doctor to see the esophagus in detail.

Manometry

Another invasive test called a manometry can be used to check the inside of your throat. More specifically, this test checks the pressure of the muscles in your throat when you swallow. The doctor will insert a tube into your esophagus to measure the pressure in your muscles when they contract.

Swallowing difficulties may improve on their own without treatment.

However, if swallowing problems are persistent, they can result in malnutrition and dehydration, especially in the very young and elderly, and recurrent respiratory infections and aspiration pneumonia. All of these complications are serious and life-threatening and must be treated definitively.

If symptoms are mild and intermittent, your doctor may show you exercises used to help strengthen the muscles in your throat. He or she may also show you swallowing techniques, which will help you to swallow the food without choking.

If your swallowing problem is caused by a tightened esophagus, a procedure called esophageal dilation may be used to expand the esophagus. During this procedure, a small balloon is placed into the esophagus to widen it. The balloon is then removed.

If there are any abnormal growths in the esophagus, surgery may be necessary to remove them. Surgery may also be used to remove scar tissue.

If you have acid reflux or ulcers, you will be given prescription medication to treat them.

In severe cases, you may be admitted into the hospital and given food through a feeding tube. This special tube goes right into the stomach and bypasses the esophagus. Liquid diets may also be necessary until the swallowing difficulty improves. This prevents dehydration and malnutrition.